Methods for detecting contaminants in solutions containing glucose polymers

ABSTRACT

The invention relates to a method for detecting contaminants of glucose polymers, said contaminants being capable of acting in synergy with one another so as to trigger an inflammatory reaction, characterized in that it comprises an in vitro inflammatory response test using modified cell lines.

The present invention relates to methods for detecting contaminants ofglucose polymers, in particular circuits for producing glucose polymers,more particularly those for peritoneal dialysis.

By extension, this method also allows the detection of contaminants ofglucose polymers, in particular circuits for producing glucose polymers,for enteral and parenteral feeding, or even the feeding of newbornbabies.

A subject of the invention is also the need for identifying thepro-inflammatory contaminants.

TECHNICAL BACKGROUND OF THE INVENTION

The Applicant company has chosen to develop its invention in a fieldwhich is known for the dangerousness of the contaminants that may beintroduced via glucose polymers, said contaminants being responsible forinflammatory reactions that are very harmful to human health: the fieldof peritoneal dialysis.

Peritoneal dialysis is a type of dialysis of which the objective is toremove waste such as urea, creatinine, excess potassium or surplus waterthat the kidneys do not manage or no longer manage to purify out of theblood plasma. This medical treatment is indicated in the event ofend-stage chronic renal failure.

It is an intracorporeal purification which uses the peritoneum as adialysis membrane. Toxic waste from the blood crosses the semi-permeablemembrane of the peritoneum, to a solution known as a dialysate. Thedialysate is introduced into the peritoneal cavity via a permanentcatheter. There are two types of peritoneal dialysis:

-   -   CAPD (continuous ambulatory peritoneal dialysis), a treatment        which is based on passing through four bags of dialysate per day        according to medical prescription,    -   APD (automated peritoneal dialysis), a continuous nocturnal        treatment which corresponds to approximately 15 liters of        dialysate per 8 hours according to medical prescription.

The dialysates most commonly used are composed of a buffer solution (oflactate or of bicarbonate) at acid pH (5.2-5.5) or physiological pH(7.4), to which electrolytes (sodium, calcium, magnesium, chlorine) andan osmotic acid (glucose or a glucose polymer, such as “icodextrin”present in the Extraneal® ambulatory peritoneal dialysis solution soldby the company Baxter) are added.

The glucose polymer, such as icodextrin mentioned above, is preferred toglucose as osmotic agent because, owing to its small size, the glucosewhich rapidly crosses the peritoneum leads to a loss of osmotic gradientin the 2 to 4 hours of infusion.

The standard glucose polymers are produced by acid or enzymatichydrolysis of starch from cereals or from tuberous plants.

Acid hydrolysis of starch, which is completely random, or enzymatichydrolysis thereof, which is slightly more ordered, provides mixtures ofglucose (monomer) and glucose chains which comprise very short molecules(oligomers), with a low degree of polymerization (or DP), and very longmolecules (polymers), with a high DP. Glucose polymers have, moreover,an extremely varied molecular weight.

In the more particular field of the use of glucose polymers forcontinuous ambulatory peritoneal dialysis, it very quickly becameapparent that these starch hydrolysates (mixture of glucose, and ofglucose oligomers and polymers) could not be used as such.

European patent application EP 207 676 teaches that glucose polymersforming clear and colorless solutions at 10% in water, having aweight-average molecular weight (Mw) of 5 000 to 100 000 daltons and anumber-average molecular weight (Mn) of less than 8 000 daltons arepreferred.

Such glucose polymers also preferably comprise at least 80% of glucosepolymers of which the molecular weight is between 5 000 and 50 000daltons, little or no glucose or glucose polymers with a DP less than orequal to 3 (molecular weight 504) and little or no glucose polymers witha molecular weight greater than 100 000 (DP of about 600).

In other words, the preferred glucose polymers are glucose polymers witha low polydispersity index (value obtained by calculating the Mw/Mnratio).

The methods proposed in that patent application EP 207 676 for obtainingthese glucose polymers with a low polydispersity index from starchhydrolysates consist:

-   -   either in carrying out a fractional precipitation of a        maltodextrin with a water-miscible solvent,    -   or in carrying out a molecular filtration of this same        maltodextrin through various membranes possessing an appropriate        cut-off or exclusion threshold.

In the two cases, these methods are aimed at removing at the same timethe very high-molecular-weight polymers and the low-molecular-weightmonomers or oligomers.

However, these methods do not provide satisfaction both from the pointof view of their implementation and from the point of view of the yieldsand the quality of the products that they make it possible to obtain.

In the interests of developing a method for producing a completelywater-soluble glucose polymer with a low polydispersity indexpreferentially less than 2.5, preferably having an Mn of less than 8 000daltons and having an Mw of between 12 000 and 20 000 daltons, saidmethod lacking the drawbacks of the prior art, the Applicant companyendeavored to solve this problem in its patent EP 667 356, by startingfrom a hydrolyzed starch rather than from a maltodextrin.

The glucose polymer obtained by chromatographic fractionation thenpreferably contains less than 3% of glucose and of glucose polymershaving a DP less than or equal to 3 and less than 0.5% of glucosepolymers having a DP greater than 600.

It is finally henceforth accepted by experts in the field of peritonealdialysis that these glucose polymers, used for their osmotic power, areentirely satisfactory.

However, risks of microbial contamination of these preparations intendedfor peritoneal dialysis are to be deplored.

It is in fact known that glucose polymer production circuits can becontaminated with microorganisms, or with pro-inflammatory substancescontained in said microorganisms.

The contamination of corn or wheat starches with microorganisms ofyeast, mold and bacteria type, and more particularly withacidothermophilic bacteria of Alicyclobacillus acidocaldarius type(extremophilic bacteria which grow in the hot and acidic zones of thecircuit) is, for example, described in the starch industry.

The major risk for the patient who receives these contaminated productsis then peritonitis.

Clinical suspicion of peritonitis is diagnosed when there is a cloudydialysate together with variable clinical manifestations, namelyabdominal pain, nausea, vomiting, diarrhea and fever.

These episodes of peritonitis are caused by intraperitoneal bacterialinfections, and the diagnosis usually easily established throughpositive dialysate cultures.

“Sterile peritonitis”, which is also described as aseptic, chemical orculture-negative peritonitis, is, for its part, typically caused by achemical irritant or a foreign body.

Since the introduction of icodextrin for the preparation of peritonealdialysis solutions, isolated cases of aseptic peritonitis have beenreported, that can be linked to various causes, and in particularinduction by pro-inflammatory substances potentially present.

Aseptic inflammatory episodes are therefore major complications observedafter injections of dialysis solutions.

While some of these inflammatory episodes are linked to a problem ofchemical nature (accidental injection of chemical contaminants orincorrect doses of certain compounds), the majority of cases aredirectly associated with the presence of contaminants of microbialorigin that are present in the solutions used to prepare the dialysissolutions.

Lipopolysaccharides (LPSs) and peptidoglycans (PGNs) are the maincontaminants of microbial origin which present a high risk of triggeringan inflammation when they are present in trace amounts.

The standard tests theoretically make it possible to discard batcheswhich are loaded with contaminants of this type and which thereforepresent a health risk. However, these tests are not satisfactory, sinceaseptic inflammatory episodes are still reported, even though thesolutions had been declared healthy.

Thus, despite the constant attention of those participating the field,in terms of reducing the risk of contaminations, in particular byimproving detection thereof, there still remains a need to improve theperformance levels of the detection of contaminants which can induce aninflammation.

DETAILED DESCRIPTION OF THE INVENTION

It is to the Applicant company's credit to have taken into account thepresence of molecules capable of exacerbating the inflammatory responseinduced by other contaminants, in particular LPS or PGNs, especially viaa mechanism of cooperation between TLRs (Toll-Like Receptors) and NOD(Nucleotide-binding Oligomerization Domain-containing protein)-likereceptors. Indeed, to consider only the effect of the isolatedcontaminants on inflammation is reductive.

Contrary to LPS, which is a ligand recognized by receptors of TLR4(Toll-Like Receptor) type, PGN (but also numerous glycolipids andlipopeptides) is a ligand recognized by receptors of TLR2 type whichinduces a weak inflammatory response in in vitro and in vivo models,thereby implying that these molecules must be present at higherconcentrations in order to be detected.

Thus, in the models using mononuclear cells (PBMCs, primarymonocytes/macrophages or monocyte lines), LPS induces a significantresponse for concentrations of about 1 ng/ml, whereas PGN concentrationsat least 100 times higher are required to obtain a similar response (w/wratio).

In addition, while soluble PGNs (MW≈125 kDa) induce an inflammatoryresponse via the activation of TLR2, the depolymerization productsthereof, the minimum structure of which still bioactive is muramyldipeptide (MDP), interact with NOD-like intracellular receptors.

These derivatives, considered in isolation, are not very inflammatory invitro and give a significant response for values >1 μg/ml.

On the other hand, the presence of these molecules has a synergisticeffect on the inflammatory response, by a mechanism of cooperationbetween TLRs and NOD-like receptors, regardless of the experimentalmodel used (mouse, monocyte/macrophage lines, blood mononuclear cells).

In addition to the PGN depolymerization products, formylated microbialpeptides, the prototype of which is f-MLP (formyl-Met-Leu-Phetripeptide), also have a substantial synergistic activity. Originally,these peptides were identified for their chemoattractant activity onleukocytes, although they are incapable of inducing a cytokine responseper se.

However, when they are combined with TLR agonists, they contribute toincreasing cytokine production by sensitizing target cells.

It is therefore important not to ignore these “small molecules”, sincethey can indirectly account for aseptic inflammatory episodes byexacerbating the effects of traces of PGN and/or of LPS.

Over the last few years, many tests using primary cells have beendeveloped in order to replace animal models in inflammatory responsetests.

However, these in vitro models are subject to considerableinterindividual variability, which can be responsible for experimentalbiases.

Conversely, monocyte cell lines give constant responses, therebyexplaining why the tests currently undergoing development increasinglyuse cells of this type in culture. However, these tests have thedrawback of giving an overall inflammatory response to all thecontaminants present as a mixture in a solution, and consequently do notmake it possible to characterize the nature of the contaminant.

It is also important to note that the exacerbated inflammatory responseis visible for cytokines of the acute phase of the inflammation, such asTNF-α (Tumor Necrosis Factor alpha), IL-1β (interleukin-1β) andchemokines such as CCL5 (Chemokine (C-C motif) ligand 5)/RANTES(Regulated upon Activation, Normal T-cell Expressed, and Secreted), butnot or barely for IL-6 (interleukin 6). Thus, the methods based on theproduction of the latter (US2009/0239819 and US2007/0184496) are notsuitable for detecting contaminants as a mixture in a solution.

Thus, the Applicant company has come to the following conclusions:

-   -   (i) it is difficult to detect bacterial contaminants present in        trace amounts in biological solutions,    -   (ii) it is important not to be limited to the detection of PGNs        and of LPS, owing to the synergistic effects,    -   (iii) it is necessary to develop new detection methods which are        sensitive and reproducible, and    -   (iv) it is advantageous to use sensitive and reproducible        detection methods capable of characterizing the nature of the        contaminants.

It is therefore to the Applicant company's credit to have developedsensitive and effective methods for detecting microbial contaminantswhich have a pro-inflammatory action, below the threshold of sensitivityof the procedures currently used and/or described in the literature, andsubsequently for identifying the family, or even the nature, of thepro-inflammatory molecules present in trace amounts in the batchesoriginating from the production circuits.

Indeed, a very sensitive method for measuring inflammatory responses invitro will make it possible to retain or not retain batches on the basisof contamination levels which are “not significant”, in the sense thatthese levels will be lower than the levels currently measurable usingthe standard tests.

It will be possible to propose these batches for making up thecomposition of solutions for therapeutic use in humans (e.g. peritonealdialysis solutions).

Furthermore, the identification of the molecules responsible for theinflammatory responses shall make it possible to detect the sources ofcontaminations during production methods, and to introduce correctivemodifications in order to reduce the levels of contaminants, or eveneliminate them.

The method in accordance with the invention therefore relates to amethod for detecting the pro-inflammatory contaminants of glucosepolymers, in particular those for the preparation of a peritonealdialysis solution, comprising an in vitro inflammatory response test.

The glucose polymers may be for peritoneal dialysis, enteral andparenteral feeding and the feeding of newborn babies. In one preferredembodiment, the glucose polymers that will be tested using the methodsof the present invention are icodextrin or maltodextrins. They can betested at one or more stages of their preparation, and in particular atthe level of the raw material, at any step in their preparation process,and/or at the level of the final product of the process. They can alsobe tested as a sample of a peritoneal dialysis solution.

As previously mentioned, some molecules of bacterial origin, such as MDPand f-MLP, are weak inflammatory inducers, but they can act incombination or in synergy and increase the response induced by othercontaminants.

This property is based on the fact that the molecules act via theintervention of receptors other than TLRs.

Besides LPS which reacts with TLR4, the majority of molecules with aninflammatory potential that may be present in the batches are TLR2agonists.

These contaminants are difficult to detect, since they are present inlow concentrations and the inflammatory response that they will triggeris most commonly close to the background noise.

Consequently, the presence of molecules with synergistic activity canexacerbate the inflammatory response induced by TLR2 ligands, which canbe taken advantage of for detecting low doses of contaminants.

Samples contaminated with MDP (NOD2 agonist), f-MLP (microbial peptidereceptor ligand), or even with LPS (for triggering TLR4/TLR2 synergy)will as a result trigger an in vitro inflammatory response.

Thus, the pro-inflammatory contaminants detected by means of the methodof the invention are capable of triggering, separately or incombination, an inflammatory reaction. In particular, these contaminantsmay be weak inflammatory inducers when they are considered separately,but may induce a substantial inflammatory reaction when they are incombination. The method according to the invention makes it possible toconsider the effect of the set of contaminants present in the glucosepolymer preparation under consideration and not only the particulareffect of each of them.

The method according to the invention comprises at least one in vitroinflammatory response test using a cell line which makes it possible todetect at least one inflammatory response factor. Preferably, the cellline is either a macrophage or a macrophage-differentiated cell line, ora cell expressing one or more TLRs or NOD-like receptors such as TLR2,TLR4 or NOD2, or a combination thereof.

According to a first embodiment, the cell line used in the inflammatoryresponse test is a macrophage or a macrophage-differentiated cell line.In particular, the cell line produces TNF-α and the chemokineCCL5/RANTES. Preferably, the test is carried out withmacrophage-differentiated THP-1 cells.

In one preferred embodiment, the macrophages ormacrophage-differentiated cells, in particular themacrophage-differentiated THP-1 cells, are used at a density of between0.5 and 1×10⁶ cells/ml of culture medium, preferably between 0.7 and0.8×10⁶ cells/ml, and even more preferably approximately 0.75×10⁶cells/ml.

The in vitro inflammatory response test can be based on the productionof TNF-α and/or of the chemokine CCL5/RANTES by macrophages, inparticular macrophage-differentiated THP-1 cells, given that thesynergistic effect (effect obtained via the combination of these variouscontaminants) is especially marked for the cytokines of the acute phaseof inflammation (TNF-α, IL-1β, chemokines), but not for cytokines of thedelayed phase, such as IL-6.

Thus, according to one particular embodiment, the inflammatory responsetest consists in placing the cells of the cell line, preferablymacrophages, in the presence of a preparation of glucose polymers thatmay contain pro-inflammatory contaminants and in measuring theproduction of cytokines of the acute phase of inflammation, inparticular TNF-α, IL-1β and/or chemokines, in particular CCL5/RANTES,the production of these cytokines indicating that the preparationcontains contaminants capable of triggering an inflammatory reaction. Inone particularly preferred embodiment, the test comprises measuring theproduction of TNF-α and/or of CCL5/RANTES, preferably of CCL5/RANTES.The cytokine assays can be carried out by any means well known to thoseskilled in the art, and in particular by ELISA. In one preferredembodiment, the test comprises measuring the production of TNF-α after 8h of stimulation. In another preferred embodiment, the test comprisesmeasuring the production of RANTES after 20 h of stimulation, inparticular by means of an ELISA assay.

In order to increase the cell response induced by pro-inflammatorycontaminants, for example by LPSs and/or PGNs, a component which makesit possible to act in synergy with the contaminants can be added to thetest sample. Indeed, this can make it possible to detect lower doses ofcontaminants. Preferably, this component may be MDP or a relatedmolecule (N-glycolyl-MDP, L18-MDP), a formylated microbial peptide(f-MLP), or LPS. Preferably, this component is MDP, f-MLP or LPS. Evenmore preferably, this component is MDP or LPS. In particular, the LPS isan E. coli LPS.

In one preferred embodiment, MDP, in particular S. aureus MDP, is addedto the sample. Preferably, the MDP is added to the sample at aconcentration of more than 1 μg/ml, preferably at a concentration ofbetween 1 and 100 μg/ml. In one most particularly preferred embodiment,the MDP is added to the sample at a concentration of 10 μg/ml.

In another preferred embodiment, the f-MLP is added to the sample at aconcentration of more than 10 nM, preferably of at least 50, 100, 150,200, 300, 400 or 500 nM.

In yet another preferred embodiment, the LPS, in particular an E. coliLPS, can be added to the sample at a concentration of at least 10 pg/ml,for example at a concentration of 25 pg/ml.

In one preferred embodiment, the glucose polymer preparation tested hasa glucose polymer concentration of from 5 to 50 mg/ml, preferablybetween 5 and 10, 20, 30 or 40 mg/ml. In one particular embodiment, theglucose polymer preparation tested has a glucose polymer concentrationof approximately 5 mg/ml. In one preferred embodiment, the glucosepolymer preparation tested has a glucose polymer concentration ofapproximately 25 mg/ml.

Optionally, a sample of the glucose polymer preparation can be treatedwith a mutanolysin prior to the test. This enzyme, through itsmuramidase activity, is capable of depolymerizing PGNs. For example, theenzyme at a concentration of approximately 2500 U/ml can be placed inthe presence of the sample, optionally diluted so as to have a glucosepolymer concentration of from 7.5 to 37.5% (weight/volume), for 6 to 16h, preferably approximately 16 h. The sample thus treated will then besubjected to the test with macrophages according to the presentinvention. Optionally, the result, i.e. the cytokine production,obtained with the sample treated with a mutanolysin may be compared withthe result obtained without treatment.

Optionally, in another alternative, the sample of the glucose polymerpreparation can be filtered prior to the test. The purpose of thisfiltration is essentially to remove the high-molecular-weight molecules,such as the high-molecular-weight PGNs, and to perform the test on thefiltrate in order to analyze most particularly the contaminants of smallsizes. The cut-off threshold for the filtration can, for example, bebetween 30 kD and 150 kD, preferably between 30 and 100 kD or between 30and 50 kD, and in particular approximately 30 kD. Preferably, thefiltration is carried out by ultrafiltration. It can also be carried outby any means known to those skilled in the art. Thus, the sample thusfiltered, the filtrate, will be subjected to the test with macrophagesaccording to the present invention. Optionally, the result, i.e. thecytokine production, obtained with the filtrate may be compared with theresult obtained without or before filtration. This will make it possibleto deduce the specific inflammatory contribution of the molecules ofsmall sizes.

In one preferred and particular embodiment, the method has one or moreof the following characteristics:

-   -   the cell line is used at a density of between 0.5 and 1×10⁶        cells/ml, preferably between 0.7 and 0.8×10⁶ cells/ml, and even        more preferably approximately 0.75×10⁶ cells/ml; and/or    -   the glucose polymer concentration is less than 50 mg/ml,        preferably approximately 25 mg/ml; and/or    -   the cytokine production is measured after 20 h of stimulation        for RANTES and/or 8 h of stimulation for TNF-α; and/or    -   MDP is added, to the glucose polymer preparation, at a        concentration of between 1 and 100 μg/ml, preferably        approximately 10 μg/ml.

Preferably, the method comprises all the characteristics.

Thus, in one very particular mode, the method comprises:

-   -   placing macrophages in the presence, for approximately 20 h, of        a preparation of glucose polymers that may contain        pro-inflammatory contaminants in the presence of MDP, preferably        at a concentration of between 1 and 100 μg/ml, the glucose        polymer concentration being less than 50 mg/ml, preferably        approximately 25 mg/ml, and the macrophages having a density of        between 0.5 and 1×10⁶ cells/ml, preferably between 0.7 and        0.8×10⁶ cells/ml, and even more preferably approximately        0.75×10⁶ cells/ml; and    -   measuring the production of CCL5/RANTES, the production of        CCL5/RANTES indicating that the preparation contains        contaminants capable of triggering an inflammatory reaction.

Quite particularly, this first embodiment makes it possible to detectthe contamination of the glucose polymer with PGNs and/or LPS,preferably with medium-sized PGNs (in particular of approximately 120kDa) and/or LPS, even more particularly with LPSs.

In particular, the method can comprise the quantification of thecontaminants. For example, this quantification can be carried out usinga dose-response curve. This dose-response curve can in particular beproduced with the same cells, under the same conditions, with increasingdoses of contaminants. Preferably, such a dose-response curve can beproduced with increasing doses of LPS.

This first embodiment can be implemented in the methods according to thepresent invention alone or in combination with a second embodiment.

According to the second embodiment, the cell line used to carry out thein vitro inflammation test is a line which makes it possible to detectthe activity of one or more innate immunity receptors.

In particular, this cell line can be obtained by stable transfectionwith one or more vectors encoding one or more innate immunity receptors.

The activity of an innate immunity receptor can be detected, forexample, by using a reporter gene which is under the direct control ofthe signaling pathway associated with said receptor. Preferably, thisreporter gene encodes a colored or fluorescent protein or encodes aprotein of which the activity can be measured with or without asubstrate. In particular, the reporter gene encodes an alkalinephosphatase.

Thus, the method comprises placing one or more cell lines expressing oneor more TLRs or NOD-like receptors in the presence of the preparation ofglucose polymers and measuring the activity of the receptors, inparticular by means of the signal of a reporter gene.

This reporter gene signal indicates the presence in the preparation of acontaminant which is an agonist of the receptor.

Preferably, the cell line makes it possible to detect the activity ofone or more TLRs or NOD-like receptors, such as the TLR2, 3, 4, 5, 7, 8or 9 or NOD2 receptors. Preferably, the cell line makes it possible todetect the activity of one or more receptors chosen from TLR2, TLR4 andNOD2. In one particular embodiment, the cell line expresses the TLR2,TLR4 and NOD2 receptors and makes it possible to detect their activity.

The cell lines used may, for example, be HEK-Blue™ lines (sold by thecompany InvivoGen), modified by stable transfection with vectorsencoding innate immunity receptors. However, it should be noted thatthose skilled in the art can also use other commercially available lines(Imgenex) or they can prepare them.

These cells can also be cotransfected with a reporter gene producing,for example, a secreted form of alkaline phosphatase (SEAP: secretedembryonic alkaline phosphatase), the synthesis of which is under thedirect control of the signaling pathway associated with the receptor(s)expressed in the same cell line. In one preferred embodiment, theenzymatic reaction is carrying out using a 1:3 ratio of test mediumversus SEAP reagent (for example, 50 μl of medium and 150 μl of SEAPreagent). In addition, a reaction time of at least 60 minutes will bepreferred.

The cell lines can, for example, be chosen from the group consisting of:

-   -   the HEK-Blue™ hTLR2 line (line which responds specifically to        TLR2 agonists),    -   the HEK-Blue™ hNOD2 line (line which responds effectively to PGN        depolymerization products and to related molecules (MDP,        L18-MDP, etc.), and    -   the Raw-Blue™ line (mouse macrophage line transfected so as to        express an alkaline phosphatase). The Raw-Blue™ line expresses        innate immunity receptors, and particularly the TLR2, TLR4 and        NOD2 receptors.

These lines are detailed later in this description.

In one preferred embodiment, a line expressing TLR2 and making itpossible to detect its activity, and/or a line expressing the TLR2, TLR4and NOD2 receptors and making it possible to detect their activity willbe used. By way of example, the HEK-Blue™ hTLR2 and/or Raw-Blue™ celllines will be used. Most particularly, the method will implement a testusing the HEK-Blue™ hTLR2 and Raw-Blue™ cell lines.

In another preferred embodiment, two lines expressing respectively TLR2and NOD2 and making it possible to detect their activity (separately),and one line expressing the TLR2, TLR4 and NOD2 receptors and making itpossible to detect their activity will be used. By way of example, theHEK-Blue™ hTLR2, HEK-Blue™ hNOD2 and Raw-Blue™ cell lines will be used.Most particularly, the method will implement a test using the HEK-Blue™hTLR2, HEK-Blue™ hNOD2 and Raw-Blue™ cell lines.

The use of such lines therefore makes it possible to replace thecytokine assays with an enzymatic test (phosphatase activity), and totarget certain families of molecules of bacterial origin according tothe receptor(s) expressed by the line.

In addition, these lines make it possible to detect contaminants at verylow thresholds, in particular for TLR2 agonists (PGN, LTA (lipoteichoicacid), LM (Lipomannan), etc.) and NOD2 agonists (PGN depolymerizationproducts and MDP). Thus, the line expressing NOD2, in particularHEK-Blue™ hNOD2, makes it possible most particularly to detect acontamination with PGN depolymerization products and MDP, preferablyMDP. The line expressing TLR2, in particular HEK-Blue™ hTLR2 and/orRaw-Blue™, makes it possible most particularly to detect a contaminationwith PGNs.

According to this second embodiment, the in vitro inflammatory responsetest consists in placing the cells of the cell line making it possibleto detect the activity of one or more innate immunity receptors in thepresence of a preparation of glucose polymers that may containpro-inflammatory contaminants and in measuring the activity of thereceptor or of the signal of the reporter gene that is associatedtherewith.

The detection of this activity or of this signal indicates that thepreparation contains contaminants capable of activating one or moreinnate immunity receptors and of triggering an inflammatory reaction.

In one preferred embodiment, the glucose polymer preparation tested hasa glucose polymer concentration of from 5 to 50 mg/ml, preferablybetween 5 and 10, 20, 30 or 40 mg/ml. In one particular embodiment, theglucose polymer preparation tested has a glucose polymer concentrationof approximately 5 mg/ml. In the preferred embodiment, the glucosepolymer preparation tested has a glucose polymer concentration ofapproximately 37.5 mg/ml when HEK-Blue™ hTLR2 and/or HEK-Blue™ hNOD2cells are used. In another preferred embodiment, the glucose polymerpreparation tested has a glucose polymer concentration of approximately50 mg/ml when Raw-Blue™ cells are used.

Optionally, a sample of the glucose polymer preparation can be treatedwith a mutanolysin prior to the test. This enzyme, through itsmuramidase activity, is capable of depolymerizing PGNs. For example, theenzyme at a concentration of 2500 U/ml can be placed in the presence ofthe sample, optionally diluted so as to have a glucose polymerconcentration of from 7.5% to 37.5% (weight/volume), for 6 to 16 h,preferably approximately 16 h. The sample thus treated will then besubjected to the methods according to the second embodiment. Optionally,the result obtained with the sample treated with a mutanolysin may becompared with the result obtained without treatment.

Optionally, in another alternative, the sample of the glucose polymerpreparation can be filtered prior to the test. The purpose of thisfiltration is essentially to remove the high-molecular-weight molecules,such as the high-molecular-weight PGNs, and to carry out the test on thefiltrate in order to analyze most particularly the contaminants of smallsizes. The cut-off threshold for the filtration can, for example, bebetween 30 kD and 150 kD, preferably between 30 and 100 kD or between 30and 50 kD, and in particular approximately 30 kD. Preferably, thefiltration is carried out by ultrafiltration. It can also be carried outby any means known to those skilled in the art. Thus, the sample thusfiltered, the filtrate, will be subjected to the methods according tothe second embodiment. Optionally, the result obtained with the filtratemay be compared with the result obtained without or before filtration.This will make it possible to deduce the specific inflammatorycontribution of the molecules of small sizes.

In one preferred and particular embodiment of this second embodiment,the method has one or more of the following characteristics:

the cell line is used at a density of approximately 50 000 cells/wellfor a 96-well plate and for HEK-Blue™ hTLR2 or Raw-Blue™ and of 10 000cells/well for a 96-well plate for HEK-Blue™ hNOD2; and/or

the glucose polymer preparation tested has a glucose polymerconcentration of from 5 to 50 mg/ml, preferably a glucose polymerconcentration of approximately 37.5 mg/ml when HEK-Blue™ hTLR2 and/orHEK-Blue™ hNOD2 cells are used and a glucose polymer concentration ofapproximately 50 mg/ml when Raw-Blue™ cells are used; and/or

the bringing of the glucose polymer preparation into contact with thecells lasts approximately 16 to 24 h; and/or

the signal of the SEAP reporter gene is detected with a culturesupernatant:SEAP substrate ratio of 20:180, preferably of 50:150,preferably after at least 60 minutes of incubation, ideally 60 minutes.

In one particular embodiment, the method comprises all thecharacteristics.

In particular, the method may comprise the quantification of thecontaminants. For example, this quantification can be carried out usinga dose-response curve. This dose-response curve can in particular beproduced with the same cells, under the same conditions, with increasingdoses of contaminants. Preferably, such a dose-response curve can beproduced for the cells expressing TLR2 (for example, HEK-Blue™ hTLR2 andRaw-Blue™) with increasing doses of PGN and for the cells expressingNOD2 (for example, HEK-Blue™ hNOD2) with increasing doses of MDP.

The method according to the invention can thus also comprise a stepconsisting in identifying the contaminant(s) capable of triggering aninflammatory reaction.

For this, a cell line making it possible to detect the activity of aninnate immunity receptor or several innate immunity receptors, asdescribed above, is placed in the presence of the glucose polymerpreparation to be tested. The activity of the receptor or the signal ofthe reporter gene associated with this receptor is measured. Thedetection of this activity or of this signal indicates the presence, inthe preparation, of a contaminant which is an agonist of the receptor.

Thus, the line expressing NOD2, in particular HEK-Blue™ hNOD2, makes itpossible most particularly to detect a contamination with PGNdepolymerization products and MDP, preferably MDP. The line expressingTLR2, in particular HEK-Blue™ hTLR2 and/or Raw-Blue™, makes it possiblemost particularly to detect a contamination with PGNs. Moreover, themacrophages, in particular the THP-1 macrophages, make it possible mostparticularly to detect a contamination with LPSs.

According to one embodiment, the method according to the inventioncomprises the steps consisting in

(a) carrying out at least one in vitro inflammatory response test, asdescribed above in the first embodiment, consisting in placing the cellsof a cell line, preferably macrophages, in the presence of a preparationof glucose polymers that may contain pro-inflammatory contaminants andin measuring the production of cytokines of the acute phase ofinflammation, in particular TNF-α, IL-1β and/or chemokines such asCCL5/RANTES, the production of these cytokines indicating that thepreparation contains contaminants capable of triggering an inflammatoryreaction, and/or

(b) placing a cell line which makes it possible to detect the activityof an innate immunity receptor or several innate immunity receptors, asdescribed above in the second embodiment, in the presence of thepreparation and detecting the activity of the receptor or the signal ofthe reporter gene associated with this receptor, the detection of thisactivity or of this signal indicating the presence, in the preparation,of a contaminant which is an agonist of the receptor.

According to one preferred embodiment, the method according to theinvention comprises the steps consisting in

(a) carrying out at least one in vitro inflammatory response testconsisting in placing the cells of a cell line, preferably macrophages,in the presence of a preparation of glucose polymers that may containpro-inflammatory contaminants and measuring the production of cytokinesof the acute phase of inflammation, in particular TNF-α, IL-1β, and/orchemokines such as CCL5/RANTES, the production of these cytokinesindicating that the preparation contains contaminants capable oftriggering an inflammatory reaction, and

(b) when the preparation contains contaminants, placing a cell linewhich makes it possible to detect the activity of an innate immunityreceptor or several innate immunity receptors, as described above, inthe presence of the preparation and detecting the activity of thereceptor or the signal of the reporter gene associated with thisreceptor, the detection of this activity or of this signal indicatingthe presence, in the preparation, of a contaminant which is an agonistof the receptor.

Steps a) and b) of this method are carried out according to the detailsprovided above. Preferably, the method comprises the two steps.

In one preferred embodiment, a cell line expressing the TLR2 receptorand making it possible to detect its activity, such as HEK-Blue™ hTLR2,and/or a line expressing several innate immunity receptors, as describedabove, in particular TLR2, TLR4 and NOD2, such as Raw-Blue™, will beused. Most particularly, the method will implement a test using theHEK-Blue™ hTLR2 and Raw-Blue™ cell lines.

In another preferred embodiment, a cell line expressing the TLR2receptor and making it possible to detect its activity, such asHEK-Blue™ hTLR2, a cell line expressing the NOD2 receptor and making itpossible to detect its activity, such as HEK-Blue™ hNOD2 and/or a lineexpressing several innate immunity receptors, as described above, inparticular TLR2, TLR4 and NOD2, such as Raw-Blue™, will be used. Mostparticularly, the method will implement a test using the HEK-Blue™hTLR2, HEK-Blue™ hNOD2 and Raw-Blue™ cell lines.

This method therefore makes it possible not only to detect the presenceof pro-inflammatory contaminants in a glucose polymer preparation, butalso to obtain information on the nature of these contaminants. It is inparticular possible to define whether these contaminants are agonists ofTLRs or NOD-like receptors, such as TLR2, TLR4 or NOD2. According to onepreferred embodiment, several lines can be used to provide informationadditional to that obtained, for example, with the cytokine responsetests in the differentiated THP-1 cells:

-   -   HEK-Blue™ hTLR4 line: this line responds specifically to TLR4        agonists. It makes it possible in particular to assay LPSs;    -   HEK-Blue™ hTLR2 line: this line responds specifically to TLR2        agonists. It makes it possible in particular to assay PGNs.

Its use therefore makes it possible to determine the contribution ofthese contaminants in the triggering of inflammatory responses.

In one particular embodiment, the sample of the glucose polymerpreparation can be filtered as described above, preferably with acut-off threshold of 30 kDa, in particular by ultrafiltration, in orderto remove the PGNs, in particular the PGNs of large size. Thus, thelipopeptides and glycopeptides of small size, which are other TLR2agonists, are retained in the filtrate and only their response will bemeasured by testing the filtrate.

In addition, treatment of the solutions with lysozyme and/or β-glucanasemakes it possible to eliminate the PGN and/or the β-glucans, and to thusdetermine the significance of the other TLR2 agonists that may bepresent in the contaminated batches (glycolipids and lipopeptides).Moreover, a sample of the glucose polymer preparation can be treatedwith a mutanolysin prior to the test, in particular as detailed above;

-   -   the HEK-Blue™ hNOD2 line: this line responds specifically to        NODS agonists. It makes it possible in particular to assay MDPs.

The use of this line therefore makes it possible to detect them at lowconcentrations. This analysis is all the more advantageous since thepresence of PGN implies that its degradation products are also present,and that they can act synergistically with the TLR agonists;

-   -   HEK-Blue™ Null2 line: this is a control line, the use of which        is necessary in order to verify that the glucose polymer        solutions do not induce the production of the enzyme via an        intrinsic mechanism;    -   Raw-Blue™ line: this is a mouse macrophage line transfected with        SEAP.

The advantage of this line is that it naturally expresses virtually allthe innate immunity receptors.

It serves as a positive control in the tests, since it is supposed torespond to microbial contaminants of any type.

A subject of the invention is also the means for identifying thepro-inflammatory contaminants.

LPS and PGN assays can be carried out by any means known to thoseskilled in the art. For example, the peptidoglycan content can bedetermined according to two tests:

-   -   standard SLP test sold by the company WAKO Pure Chemical        Industries Ltd.,    -   SLP-HS test, high-sensitivity test developed and validated by        the Applicant company as detailed in its patent application WO        2010/125315.

These tests have different reagents (SLP reagents, PGN standards)exhibiting biological reactivities to substantially different PGNimpurities, and thus different performance criteria:

-   -   Standard SLP test: SLP reagent n° 297-51501-Micrococcus luteus        PGN standard n° 162-18101.    -   SLP-HS (high sensitivity) test: SLP-HS kit n° 293-58301        (including a Staphylococcus aureus PGN standard).

The SLP-HS method developed by the Applicant company is more sensitive.It has limits of detection (LD) and limits of quantification (LQ) belowthe standard SLP method:

SLP-HS test LD of 1 ng/g and LQ of 3 ng/g.

Standard SLP test LD of 20 ng/g and LQ of 40 ng/g.

Thus, unless otherwise arranged, the assaying of PGNs according toconventional methods is carried out in the present application using theSLP-HS test, since, as will be exemplified hereinafter and describedbelow, the SLP-*HS test is more sensitive than the standard SLP test.

The “inflammatory response” tests as described above, for example usingthe HEK-Blue™ cells, make it possible to identify the nature of the maincontaminants (LPS, PGN, β-glucans, MDP and related molecules) and toestimate their contribution in the induction of the inflammatoryresponse.

The other contaminants that may be present in the test batches areessentially glycolipids and lipopeptides which are TLR2 agonists, ormicrobial peptides;

-   -   for the glycolipids and lipopeptides, a fractionation procedure        based on their amphiphilic nature is carried out in order to        recover them and concentrate them.

Treatment with a chloroform/methanol mixture makes it possible toextract these molecules from the glucose polymer solutions and toconcentrate them after evaporation of the chloroform.

Once the molecules have been recovered, they are taken up in a minimumvolume of DMSO (or any other solvent that is nontoxic for the cells) andthen analyzed in the inflammatory response tests previously described.

Thus, the use of a cell line which makes it possible to detect theactivity of a receptor such as TLR2, for example the HEK-Blue™ hTLR2line, makes it possible to confirm the presence or absence of traces ofTLR2 agonists other than the PGN in the batches to be analyzed.

The compounds can also be tested in a model using cells expressing allthe types of receptors, such as the Raw-Blue™ cells, but, in this case,the glucose polymer solutions are pretreated on Detoxi-gel, so as toremove the traces of LPS.

Depending on the amounts recovered, a finer analysis of the contaminantsis carried out.

In particular, the sample can be filtered. For example, the sample ofthe glucose polymer preparation can be filtered with a cut-off thresholdof 30 kDa, in particular by ultrafiltration. This makes it possible toremove the PGNs, in particular the PGNs of large size. Thus, thelipopeptides and the glycopeptides of small size, which are other TLR2agonists, are retained in the filtrate and the filtrate can be analyzedin order to determine the nature of the contaminants.

Moreover, treatment with the chloroform/methanol mixture makes itpossible to extract the products which are subsequently fractionated onC18 resin and/or a carbon column. The compounds are then eluted using awater/acetonitrile gradient. Depending on the purity of the fractionsand on the amount of material, a more fine analysis makes it possible todetermine the biochemical nature of these compounds, or even theirstructure.

For the microbial peptides, an ultrafiltration step on a 5 kDa filtermakes it possible to extract them from the glucose polymer solutions. Ifnecessary, passing over a carbon column makes it possible to rid thefiltrate of the more hydrophobic compounds of size <5 kDa.

The solutions are subsequently concentrated and then tested for theirbiological properties. Since these peptides are chemoattractants forleukocytes, their presence can be detected in an in vitro cell migrationtest available in the laboratory.

It may be that the glucose polymers are contaminated with othermolecules known to trigger inflammatory responses, such as flagellin,which is a TLR5 agonist protein, and derivatives of nucleic acids andrelated molecules, agonists of TLR3, 7, 8 and 9 (the first three areinvolved in reactions to compounds of viral origin, while TLR9 isactivated by DNA of bacterial origin).

In this case, the cell lines which make it possible to detect theactivity of these various TLRs, in particular HEK-Blue™ lines, areavailable and can be used to analyze the impact of these molecules ininflammatory responses.

Furthermore, the presence of oligonucleotide compounds can be confirmedor otherwise by biochemical analyses.

The method of the invention allows the detection of the contaminants ofglucose polymers for peritoneal dialysis, said contaminants beingcapable of acting in synergy with one another in order to trigger aninflammatory reaction, characterized in that it comprises at least onein vitro inflammatory response test using modified cell lines.

In one particular embodiment, the present invention also provides amethod for quantifying the PGNs in a sample, in particular of glucosepolymers for peritoneal dialysis, which comprises incubating the samplewith a cell line which makes it possible to detect the activity of theTLR2 receptor and measuring the activation of the signaling pathwayassociated with TLR2, thus making it possible to determine the amount ofPGN contained in the sample.

In particular, this line is a line modified by transfection (preferablystable transfection) with a vector encoding the TLR2 receptor.Preferably, this line does not express other innate immunity receptors.In addition, this line may contain a reporter gene which is under thedirect control of the signaling pathway associated with the TLR2receptor. Preferably, this reporter gene encodes a colored orfluorescent protein or encodes a protein of which the activity can bemeasured with or without substrate. In particular, the reporter geneencodes an alkaline phosphatase. These cells can, for example, becotransfected with a reporter gene producing, for example, a secretedform of alkaline phosphatase (SEAP: secreted embryonic alkalinephosphatase), the synthesis of which is under the direct control of thesignaling pathway associated with the TLR2 receptor. This line can, forexample, be the HEK-Blue™ hTLR2 line.

In order to determine the amount of PGN contained in the sample on thebasis of measuring the activation of the signaling pathway associatedwith TLR2, a dose-response curve is simultaneously established with acalibration range comprising increasing concentrations of PGN,preferably of S. aureus PGN.

Prior to the assay, the sample to be assayed can optionally have beenpartially purified in order to remove, for example, any bothersomecontaminants. Glycopeptides and lipopeptides can be removed from thesample by chloroform extraction. After centrifugation, the assay will becarried out on the aqueous phase, from which the contaminants oflipophilic nature have normally been removed. Fractionation on amicroconcentrator, on filters with 30 or 50 kDa thresholds, can becarried out, the assay then being carried out on the retentate. Priortreatment with β-glucanase can make it possible to refine the assay byeliminating the related molecules.

Alternatively and preferably, the sample to be assayed is treated priorto the assay with a mutanolysin. For example, the enzyme at aconcentration of approximately 2500 U/ml can be placed in the presenceof the sample, preferentially diluted so as to have a glucose polymerconcentration of from 7.5% to 37.5% (weight/volume) if this isnecessary. The treatment can last for 6 to 16 h, preferably forapproximately 16 h. In the preferred embodiment, the treatment iscarried out for approximately 16 h at approximately 37° C. on a samplehaving a glucose polymer concentration of approximately 7.5%(weight/volume). The sample thus treated will then be brought intocontact with cells expressing TLR2, in particular HEK-Blue™ hTLR2 cells.Optionally, the result obtained with the sample treated with amutanolysin may be compared with the result obtained without treatment.

This same method can also be carried out for detecting the contaminantsof glucose polymers for enteral and parenteral feeding, or even for thefeeding of newborn babies.

The invention will be understood more clearly by means of the exampleswhich follow, which are meant to be illustrative and nonlimiting.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1: Production of RANTES in response to the PGN and to the LPS inTHP-1 cells sensitized with MDP at 10 μg/ml.

FIG. 2: Production of TNF-α in response to the PGN and to the LPS inTHP-1 cells sensitized with MDP at 10 μg/ml.

FIG. 3: Production of RANTES in response to the PGN in THP-1 cellssensitized with f-MLP (10 nM).

FIG. 4: Production of RANTES in response to the PGN in THP-1 cellssensitized with LPS (25 pg/ml).

FIG. 5: Effect of the glucose polymer concentration on the production ofRANTES induced by the PGN in the THP-1 cells.

FIG. 6: Effect of the THP-1 cell concentration on the production ofRANTES induced by the PGN.

FIG. 7: Production of RANTES by the sensitized THP-1 cells in responseto the various glucose polymer samples.

FIG. 8: HEK-Blue cell response test. The cells were stimulated with PGN,MDP and TNF-α, which is a positive control for stimulation of theHEK-Blue™ cells.

FIG. 9: SEAP response as a function of the volume of culture supernatantadded to the reaction medium. The activation of the cells (HEK-TLR2) wascarried out with TNF-α.

FIG. 10: Optimization of the reaction time between the SEAP and itssubstrate. The HEK-TLR2 (FIG. 10A) and Raw-Blue (FIG. 10B) cells werestimulated in the presence of increasing concentrations of PGN. After 20h of stimulation, the supernatants containing the SEAP were incubated inthe presence of the Quanti-blue solution at the times indicated, andthen the absorbance was measured at 620 nm.

FIG. 11: Effect of the glucose polymer concentration on the productionof SEAP by the HEK-TLR2 (FIG. 11A) and Raw-Blue (FIG. 11B) cells inresponse to increasing concentrations of PGN.

FIG. 12: Comparison of the SEAP responses of the HEK-NOD2 cells culturedaccording to the method provided by the supplier versus the improvedprocedure without a subculturing step before stimulation.

FIG. 13: Production of SEAP in response to the PGN in HEK-TLR2 andHEK-Null cells.

FIG. 14: Production of SEAP in response to the LTA in HEK-TLR2 andHEK-Null cells.

FIG. 15: Production of SEAP in response to the PGN and to the LPS inRaw-Blue cells.

FIG. 16: Production of SEAP in response to the MDP in HEK-NOD2 cells.

FIG. 17: SEAP activity in HEK-TLR2 cells in response to the variousglucose polymer samples.

FIG. 18: SEAP activity in Raw-Blue cells in response to the variousglucose polymer samples.

FIG. 19: SEAP activity in HEK-NOD2 cells in response to the variousglucose polymer samples.

FIG. 20: SEAP production in Raw-Blue and HEK-TLR2 cells in response tothe various glucose polymer samples before (Total) and afterultrafiltration at 30 kDa (Filtrate).

FIG. 21: Calibration curve of the cell response as a function of thelevel of S. aureus PGN. FIG. 21A, theoretical curve. FIG. 21B, curveobtained with HEK-Blue™-hTLR2 cells.

FIG. 22: SEAP activity in HEK-TLR2 cells in response to various glucosepolymer samples before and after treatment with the mutanolysin.

FIG. 23: SEAP production by HEK-TLR2 cells in response to the PGN beforeand after treatment with the mutanolysin.

EXAMPLE 1 Preparation of the Glucose Polymers for Peritoneal Dialysis

The raw material for obtaining the glucose polymers according to theinvention is produced from waxy corn starch in the following way:

-   -   cleaning of the corn so as to keep exclusively the whole corn        grains,    -   steeping of the corn thus cleaned, in the presence of lactic        acid so as to soften the grains,    -   wet milling, then separation of the various constituents, i.e.        germ, cellulose husk, proteins and starch,    -   cleaning of the starch in countercurrent mode with purified        water so as to purify the starch both physicochemically and        bacteriologically,    -   centrifugation and drying of the starch,    -   suspension of the starch in purified water at a final dry matter        content of 40% and at a temperature of 45° C. to 50° C.,    -   acidification of the starch suspension by addition of HCl at a        pH <2, and raising of the temperature to 115 to 120° C. for 6 to        8 minutes,    -   flocculation of the proteins and of the fats at this pH,    -   neutralization of the suspension at pH 5,    -   filtration of the suspension through diatomaceous earth (so as        to retain the residual proteins, fats and cellulose),    -   demineralization on strong cationic resin and weak anionic        resin,    -   treatment with activated carbon at a temperature of 70-80° C.        and at a pH of from 4 to 4.5; which removes the colored        impurities and reduces the level of microbiological impurities.

The activated carbon powder which is added at a concentration between0.2% and 0.5% on a dry basis is retained on a 10 μm ceramic filterloaded beforehand with a filtering agent,

-   -   concentration by passing through a falling film evaporator,    -   spray-drying of the concentrated solution in an MSD spray dryer        sold by the company Niro.

This starch hydrolysate complies with the monograph of the EuropeanPharmacopeia (ref Maltodextrins: 1542).

-   -   pH: 4.0-7.0 for a solution at 10%,    -   I.d.: complies,    -   Loss on drying: 6% max,    -   DE: <20    -   Sulfated ash: 0.5% max    -   SO₂: 20 ppm max    -   Heavy metals: <10 ppm    -   E. coli: absent/g    -   Salmonellae: absent/10 g    -   Total viable microorganisms: 100 CFU/g max (EP 1000 CFU/g)    -   Molds: 100 CFU/g max

In addition to this, the batches produced are analyzed on the basis ofthe values of:

yeast+mold contamination: 150 CFU/10 g max, i.e. 15/g max

aerobic microorganisms: 500 CFU/10 g max, i.e. 50/g max

endotoxins (endpoint gel clot LAL test): 20 EU/g max

peptidoglycans: 2700 ng/g max

The conditions for obtaining the glucose polymers in accordance with theinvention from the starch hydrolysate thus obtained are the following:

1) Water Preparation/Water Quality

-   -   purification of the water by filtration through 3 μm; treatment        on activated carbon, demineralization on cations and anion        exchange resins, and filtration again (UA),    -   two tanks used:        -   10 m³ for dissolving the starch hydrolysate, and the            spray-dry rinsing and cleaning steps,        -   60 m³ for the main process (cleaning of the tanks, its            suspensions of activated carbon and chromatography).

3) Chromatography

-   -   solubilization of the starch hydrolysate with purified water so        as to obtain a dry matter content of 35-45% at a temperature        between 60-85° C.,    -   sterilizing filtration of the starch hydrolysate by passing it        through 0.45 μm and then 0.22 μm, carried out at a ΔP<3 bar,    -   size exclusion chromatography (SEC) separation carried out using        a continuous system composed of six series of double plates,        each of 1 m³ of resin. The resin used is a PCR145K sold by the        company Purolite.

The solution which passes through this resin has a temperature between75 and 85° C. at 35-45% dry matter content.

The duration of each sequence defines the process.

In the present case, the duration of each sequence is 15 minutes.

The control is carried out by analysis of molecular weight distributionand analysis of the chromatography yield, in the following way: (Amountof dry matter of the desired fraction)/(Amount of dry matter of thefeed).

The lowest molecular weights interact with the resin and the highmolecular weights are eluted with purified water.

The concentration is carried out by falling film evaporation at a drymatter content of 35-45%.

A heat treatment is carried out at a temperature of 120° C. for 2minutes.

Activated carbon is added between 0.5% and 1.5% of the total weight ofthe starch hydrolysate at 75° C. with cationic resins (1 to 3 l) forcontrolling the pH (4-4.5) and anionic resins (5 to 101) for controllingthe pH (5.5-6).

Filtration is carried out through polypropylene bag filters with ΔP<5bar, in 5 to 6 hours per batch.

A second and third filtration through 1.5 and 0.45 μm, and then through0.22 and 0.1 μm, and ultrafiltration through a membrane with a cut-offthreshold of about 40 000 Da are carried out.

For the spray-drying: feed at 500 kgs/h with a solution at 40% drymatter content and at 250° C. in an MSD spray dryer sold by the companyNiro.

The spray-dried product has, on exiting, a moisture content of less than6%.

The product is then cooled in a fluidized air bed comprising threecooling zones fed with air at 40, 30 and 20° C. The product obtained isthen sieved through 800 μm in order to remove the aggregates.

About 500 kgs of final product are obtained from 800 kgs of startingmaltodextrins, i.e. a yield of about 60%.

The determination of the possible contamination of the circuit iscarried out by analysis of the peptidoglycan and endotoxin content onthe final product.

For example, the contents usually observed and measured on the batchesof the final product (expressed per g of glucose polymer) are, for thecriteria specified above, the following:

-   -   Yeasts and molds: 0/g    -   Aerobic microorganisms: 0/g    -   Endotoxins (endpoint gel clot LAL test): 0.3 EU/g    -   Peptidoglycans: <3 ng/g    -   B. acidocaldarius: 1/g

EXAMPLE 2 Use of the “Sensitized” THP-1 Cell Line for DetectingPro-Inflammatory Contaminants

Materials & Methods

The THP-1 cells (88081201, ECACC) are cultured routinely in thelaboratory.

For the pro-inflammatory activation experiments, the THP-1 cells aredifferentiated for 3 days in the presence of phorbol ester (PMA). Inparticular, the cells are placed in culture in 200 μl of complete mediumin the presence of 20 nM of PMA for 72 h (final cell density: 0.75×10⁶cells/ml).

The glucose polymer samples are prepared according to example 1.

TABLE 1 Glucose polymer samples I- I- I- I- MM- MM- MP- MP- 10.01 10.0210.03 11.12 10.04 10.05 10.06 10.07 LAL Test <0.3 0.3 <0.3 0.6 1.2 9.6<0.3 38.4 (EU/g) Standard <20 755 27 530 <20 2755 <20 4613 SLP Test(ng/g) SLP-HS <3 253 12 393 <3 501 <3 645 Test (ng/g)

The standard molecules for establishing the calibration ranges are, forthe:

-   -   LAL test: E. coli O55B5 LPS    -   Standard SLP test: M. luteus PGN—Wako    -   SLP-HS test: S. aureus PGN—Wako.

The assayed PGN values differ from one Wako test to another owing to thedifferent reactivity and sensitivity of these tests and potentially totheir limited and relative specificity (in particular, possible responseto β-glucans).

The optimization studies are carried out with I-10.01 glucose polymersolutions (table 1) artificially loaded with standard inflammatorymolecules: PGN and MDP (source: S. aureus), LPS (source: E. coli), f-MLP(synthetic peptide).

The solution for dilution of the standards is I-10-01 with <0.3 EU/g ofLPS (LAL test), <20 ng/g of PGN (standard SLP test) and <3 ng/g (SLP-HStest) and used at the final concentration of 5 mg/ml.

The analyses are then carried out on a first series of samplescorresponding to various batches selected on the basis of the levels ofcontamination with impurities measured using the LAL and SLP tests (PGN,LPS and β-glucans).

The ELISA kits for assaying TNF-α and CCL5/RANTES are purchased fromAbCys, the standard agonists (PGN, LPS, f-MLP and MDP) from SigmaAldrich and InvivoGen.

The differentiated THP-1 cells (0.75×10⁶ cells/ml) are placed in culturein 200 μl of complete medium, and then incubated in the presence of thevarious test samples.

Each analysis is carried out in triplicate.

The cell supernatants are collected in order to assay the secretedcytokines after 8 h of stimulation for TNF-α, and 20 h for RANTES. TheELISA assays are carried out according to the indications given by thesupplier.

Results

The first tests consisted in testing the synergistic potential of MDPand of f-MLP, and also the PGN/LPS combination, on the production ofpro-inflammatory cytokines by the differentiated THP-1 cells.

The MDP was tested at the doses of 1, 10 and 100 μg/ml. The minimum dosedoes not induce a significant synergistic effect. On the other hand, thedoses of 10 and 100 μg/ml have a similar synergistic activity on theproduction of RANTES and of TNF-α in response to the PGN and LPS.

The results presented in FIGS. 1 and 2 clearly show a synergistic effectof MDP on the production of RANTES. On the other hand, this synergisticeffect is not very marked for TNF-α. Furthermore, the detectionthreshold (amount of PGN or of LPS giving a response greater than threetimes the SD of the background noise) is lower for RANTES (see Table 2).

The f-MLP was used at the doses of 1 nM, 10 nM and 100 nM. However, nosynergistic effect was observed in the THP-1 cells (FIG. 3).

The synergistic effect of the LPS was analyzed by adding a sub-optimaldose (25 pg/ml) to increasing doses of PGN (FIG. 4). The synergisticeffect of the two agonists is visible after assaying the two cytokines.However, the LPS-induced synergistic effect on the production of RANTESremains less than that induced by MDP.

The response was quantified by measuring the production of RANTES and ofTNF-α. In all cases, synergy is clearly visible for the RANTES assay,with a high sensitivity. This assay will therefore be preferred andretained for the rest of the experiments.

These results show that the addition of MDP at 10 μg/ml to THP-1 cells,with in return assaying of RANTES, is the most effective mode ofsensitization for detecting low levels of PGN and of LPS. In theory,these detection thresholds should make it possible to detect thecontaminants present in manufactured products.

These first analyses were carried out by diluting the standardinflammatory molecules in the presence of the I-10.01 polymer. Thesolutions were added to the THP-1 cells so as to obtain a final glucosepolymer concentration of 5 mg/ml and a final cell density of 0.75×10⁶cells/ml. In order to increase the sensitivity of the assay, the testswere carried out while varying these two parameters.

The presence of the glucose polymer does not hamper the production ofRANTES for concentrations less than or equal to 25 mg/ml. This increasein sensitivity is not linked to a pro-inflammatory effect of the polymeron the cells, since the response is identical to the background noise inthe absence of PGN (FIG. 5).

On the other hand, increasing the cell density beyond 0.75×10⁶/mlreduces the production of RANTES in response to PGN (exhaustion of theculture medium or cell modification) (FIG. 6).

The sensitivity tests with MDP at 10 μg/ml were reproduced three timesfor LPS and six times for PGN with THP-1 cells originating from distinctpreparations. The data obtained made it possible to determine thedetection thresholds and the EC50s (Table 2). For the estimation of thesensitivity, the values were brought to per g of polymer, with theconcentration of 25 mg/ml being considered.

The synergistic effect induced by MDP is identical for LPS and PGN,since it makes it possible to increase the sensitivity of the THP-1cells by a factor of 5 in both cases.

TABLE 2 Detection thresholds and EC50 for PGN and LPS in the sensitizedTHP-1 model. PGN PGN + MDP LPS LPS + MDP Detection threshold 14.5 ± 8.5ng/ml 2.8 ± 1.2 ng/ml 10 ± 7 pg/ml 2 ± 1 pg/ml EC50 1.2 ± 0.7 μg/ml 0.4± 0.2 μg/ml 0.9 ± 0.1 ng/ml 0.3 ± 0.1 ng/ml Sensitivity 580 ± 340 ng/g112 ± 48 ng/g 400 ± 280 pg/g 80 ± 40 pg/g

These studies show that the sensitized THP-1 cells can be used todevelop a sensitive inflammatory response test for detecting traces ofcontaminants in glucose polymer preparations.

The following experimental conditions are selected:

-   -   final concentration of differentiated THP-1 cells: 0.75×10⁶        cells/ml,    -   sensitizing agent: MDP (S. aureus) at 10 μg/ml,    -   final glucose polymer concentration: 25 mg/ml,    -   response: ELISA assay of the production of RANTES after 20 h of        stimulation.

In order to validate the method, the tests with the MDP-sensitized THP-1cells were carried out with the samples presented in table 1.

The test based on the production of RANTES by sensitized THP-1 cellsmakes it possible to detect the samples of polymers contaminated withLPS: polymers referenced I-11.12, MP-10.07 and, to a lesser extent,MM-10.04 and MM-10.05 (FIG. 7).

On the other hand, the samples contaminated only with PGN (e.g. I 10-02)do not give a response, thereby indicating that this cell test is moresuitable for the detection of endotoxins. However, the amplitude of theresponses is not directly proportional to the level of LPS measuredusing the LAL test (see, for example, the responses obtained withI-11.12 compared with MM-10.05), thereby suggesting that contaminantsother than PGN probably act with LPS on the response of the THP-1 cells.

The THP-1 cells respond to the solutions of control PGN, but barely ornot at all to the samples originating from batches contaminated onlywith natural PGN.

The size of the PGNs is very heterogeneous, and some of these moleculescan reach impressive weights (>10⁶ Da). The latter have low solubility,which affects their pro-inflammatory power but promotes their removal byfiltration. On the other hand, the PGNs which are soluble, andconsequently active, have an average weight of 120 kDa and are notremoved by filtration. It is therefore possible to envision that the twoWako SLP tests enable an overall assaying of all the PGNs, whereas thecell test detects only the active PGNs.

EXAMPLE 3 Use of the HEK-Blue™ (hTLR2, hNOD2, Null2) and Raw-Blue™(InvivoGen) Cell Lines for Detecting Contaminants

Materials & Methods

The HEK-Blue™ cell lines (InvivoGen) are lines modified by stabletransfection with vectors encoding innate immunity receptors. Thesecells are also cotransfected with a reporter gene which produces asecreted form of alkaline phosphatase (SEAP: secreted embryonic alkalinephosphatase), the synthesis of which is under the direct control of thesignaling pathway associated with the receptor(s) expressed in the samecell line.

For the experiments relating to the detection of inflammatorycontaminants, four lines are used:

HEK-Blue™ hTLR2 line (HEK-TLR2): this line responds specifically to TLR2agonists (in particular PGN and the majority of glycolipids andlipopeptides),

HEK-Blue™ hNOD2 line (HEK-NOD2): this line responds to MDP and relatedmolecules, such as monomeric PGNs,

HEK-Blue™ Null2 line (HEK-Null): this is a control line, the use ofwhich is necessary in order to verify that the glucose polymer solutionsdo not induce the production of the enzyme via an intrinsic mechanism,

Raw-Blue™ line: this is a mouse macrophage line transfected with SEAP.This line, which naturally expresses virtually all the innate immunityreceptors, is used as a positive control in the tests.

The Raw-Blue™ and HEK-Blue™ cells are cultured according to thesupplier's recommendations. In particular, the selection pressure forthe plasmids encoding the inflammatory molecule receptors (TLR2 or NOD2)and encoding the SEAP is provided by adding, to the culture medium, theHEK-Blue Selection/blasticidin antibiotics. At 75% confluence, the cellsare resuspended at a cell density of 0.28×10⁶ cells/ml. Beforestimulation, 180 μl of the cell suspension are distributed into theculture wells (96-well plate), i.e. 50 000 cells/well. The cells arethen stimulated for 24 h by adding 20 μl of the test samples (inten-times concentrated form). The stimulation lasts from 16 to 24 h.

The production of SEAP in response to the contaminated molecules isestimated by measuring the phosphatase activity according to theprotocol supplied by the manufacturer: 20 μl of culture supernatant arediluted in 180 μl of Quanti-Blue. The color develops at 37° C. and thereading is carried out, at various times, at 620 nm. The data areexpressed as absorbance after subtraction of the background noise,obtained by adding the same volume of nonconditioned culture medium tothe reaction medium of the enzyme.

The optimization studies are carried out with I-10.01 glucose polymersolutions (table 1) artificially loaded with standard inflammatorymolecules: PGN, LTA and MDP (source: S. aureus) and LPS (source: E.coli). The analyses are then carried out on the series of samplescorresponding to various batches selected on the basis of the levels ofcontamination with PGN and LPS (Table 1).

Results

The HEK-Blue cells are received in the form of frozen vials. Beforebeginning the inflammatory response tests, it is necessary to be sure ofthe resumption of growth of the cells and of their capacity to responseto inflammatory molecules. Furthermore, these transfected cells rapidlydegenerate after several passages, which can result in a loss of theexpression vectors for the innate immunity receptors, or even of thevector encoding the SEAP.

It is therefore recommended to verify the capacity of the cells torespond to inflammatory factors at the beginning of the placing inculture, and then after several subculturing steps. These tests arecarried out with PGN for HEK-TLR2, MDP for HEK-NOD2 and TNF-α, thelatter being a powerful activator of the NF-κB pathway. Indeed, HEKcells naturally possess the receptor of this cytokine, and willtherefore produce SEAP (the expression vector of which is under thecontrol of the NF-κB pathway) in response to TNF-α.

The results presented in FIG. 8 show the tests carried out in order toverify the resumption of growth of the three lines. As expected, theHEK-TLR2 and HEK-Null cells respond to TNF-α, with an equivalentproduction of SEAP. Furthermore, the HEK-Null line is insensitive to PGNand to MDP, whereas the HEK-TLR2 cell responds effectively only to PGN.These two lines have therefore acquired their phenotypic characteristicsand it will be possible to use them for the rest of the experiments. Inthis example, the HEK-NOD2 line responds only very weakly to TNF-α andto MDP, thereby indicating that it has not acquired the expectedcharacteristics.

The response of the HEK-Blue and Raw-Blue cells to the pro-inflammatorymolecules is directly linked to the production of SEAP. The supplierrecommends adding 20 μl of culture supernatant to 180 μl of SEAPsubstrate. The experiments were therefore carried out under theseconditions, and then optimized by increasing the volume of culturesupernatant, and therefore the amount of enzyme in solution (FIG. 9).

The results show that the 50/150 ratio gives a higher response than theratio recommended by the supplier. On the other hand, the ratio 100/100is not more effective, probably due to a lack of SEAP substrate in thereaction medium.

The intensity of the coloration (620 nm) is proportional to the amountof SEAP secreted by the cells, but also to the time for hydrolysis ofthe substrate by the enzyme. Various visualization times were thereforetested using the same supernatants of the PGN-activated HEK-TLR2 andRaw-Blue cells (FIG. 10).

The optimum coloration is achieved starting from 60 min of reactionbetween the SEAP and its substrate for the HEK-TLR2 cells. A slightincrease is also observed at 90 min for the Raw-Blue cells, but thisincrease is probably linked to the fact that these cells produce lessSEAP.

The effect of the glucose polymer concentration on the cell responseswas analyzed by stimulating the HEK-TLR2 and Raw-Blue cells withstandard PGN diluted in medium supplemented with the I-10.01 polymer.The solutions were then added to the cells so as to obtain final polymerconcentrations ranging from 5 to 50 mg/ml (FIG. 11).

The concentrations up to 37.5 mg/ml do not significantly modify theamplitude of the response to PGN in the HEK-TLR2 line. An improvement inthe response to low concentrations of PGN is even noted for polymerconcentrations above 25 mg/ml, probably linked to a better dispersion ofthe contaminant. As regards the Raw-Blue cells, the production of SEAPis not modified, regardless of the glucose polymer concentration.

The HEK-NOD2 line shows a low amplitude of response to MDP and even toTNF-α, which appears to be linked to a high background noise. In thesecells, the SEAP gene is under the control of a weak promoter, which ismore sensitive to cell stress than that used for the other HEK-Bluecells. In order to reduce the background noise and to increase theamplitude of the response to the contaminants, the culture conditionswere modified so as to reduce the stress of the cells.

According to the supplier's recommendations, the cells at 75% confluenceare resuspended at a density of 0.28×10⁶ cells/ml, and then 180 μL ofthe cell suspension are distributed into the culture well (96-wellplate), i.e. 50 000 cells/well, before stimulation in the course of theday.

In the new procedure referred to as without subculturing, the HEK-NOD2cells are conditioned in wells (10 000/well) and cultured for threedays. Before stimulation, the culture medium is removed and replacedwith a medium containing 1% of FCS and the solutions to be assayed. Inthis case, the SEAP response is 5-6 times greater than the negativecontrol, which is compatible with a test for detecting MDP incontaminated solutions (FIG. 12).

These first studies show that the HEK-Blue and Raw-Blue cells can beused to develop sensitive inflammatory response tests for detectingtraces of contaminants in glucose polymer preparations.

The following experimental conditions were selected:

-   -   final glucose polymer concentration: 37.5 mg/ml for the HEK-Blue        cells, and 50 mg/ml for the Raw-Blue cells,    -   enzymatic reaction: 50 μl of conditioned medium+150 μl of SEAP        reagent,    -   minimum reaction time: 60 min.

FIGS. 13-16 show examples of assays of the SEAP activity produced by theHEK-TLR2 and Raw-Blue cells in response to various inflammatorymolecules.

The HEK-TLR2 cells respond very effectively to PGN, whereas the responseto LTA is weaker. The responses are, however, more effective than thoseobserved with cells of monocyte/macrophage type. In addition, theglucose polymer has no direct effect on the production of SEAP, since noresponse is observed in the supernatants of HEK-Null cells.

The Raw-Blue cells respond well to PGN, but are less sensitive than theHEK-TLR2 cells. The response to LPS is weak and remains much lower thanthat observed when measuring the production of RANTES by the THP-1cells.

Contrary to the other cell lines, the HEK-NOD2 cells respond effectivelyto MDP, which can be taken advantage of for detecting the PGNdegradation products.

The experiments with the standard PGNs, LPS and MDP were reproduced withdifferent cell preparations, which made it possible to determine thecharacteristics presented in table 3. For the estimation of thesensitivity, the values were brought to per g of polymer, with theconcentration of 37.5 mg/ml being considered for the HEK-Blue cells and50 mg/ml for the Raw-Blue cells.

TABLE 3 Detection thresholds and EC50 for PGN, LPS and MDP in theHEK-Blue and Raw-Blue models HEK-TLR2 line HEK-NOD2 line Raw-Blue linePGN MDP PGN LPS Detection 0.07 ± 0.04 ng/ml 1.5 ± 0.5 ng/ml 2.1 ± 1.5ng/ml 0.24 ± 0.06 ng/ml threshold EC50 3.1 ± 2.5 ng/ml 12 ± 6 ng/ml 210± 75 ng/ml >10 ng/ml Sensitivity 1.9 ± 1.1 ng/g 40 ± 13 ng/g 42 ± 30ng/g 4.8 ± 1.2 ng/g

The HEK-TLR2 and Raw-Blue lines are very effective for detecting thePGNs at low concentrations. In particular, the HEK-TLR2 line detects PGNlevels below 2 ng/g of glucose polymer, i.e. a sensitivity thresholdwhich is 50 times greater than that obtained with the sensitized THP-1cells. The Raw-Blue line effectively detects small traces of PGN, but itis not very reactive with respect to LPS, with a detection thresholdapproximately 50 times greater than that of the sensitized THP-1 cells.

In order to validate these tests, the assays were therefore carried outwith glucose polymer samples.

The HEK-TLR2 line makes it possible to detect contaminations in theI-10.02, I-11.12 and MM-10.05 batches, and, to a lesser extent, theMP-10.06 and MP-10.07 batches (the response observed with MM-10.04 isnot significant in comparison with I-10.01 and is not thereforeretained).

On the other hand, the I-10.03 sample is not detected, which can becorrelated with the very low level of PGN, close to the limit ofdetection of the SLP-Wako test (FIG. 17).

While the positive responses obtained with I-10.02, I-11.12, MM-10.05and MP-10.07 were expected, given the high level of PGN present in thesefour samples, it may be noted that there is no proportionality betweenthe concentration given by the SLP test and the response of the cells.

Indeed, the I-10.02 and I-11.12 glucose polymers give the highestresponses, whereas the PGN levels are less than 1 μg/g. Conversely, theMP-10.07 sample, which is the one with the highest PGN load, gives aresponse close to the background noise. PGNs are macromolecules of veryvariable weight, and it has been demonstrated that their reactivity isinversely proportional to their molecular weight. It can therefore beenvisioned that the PGNs of I-10.02 and I-11.12 are smaller in size thanthe PGNs present in the MM-10.05 and MP-10.07 samples, which wouldexplain their higher pro-inflammatory potential.

It is also surprising to see a response with the MP 10-06 batch, eventhough it does not contain PGN. However, the HEK-TLR2 cells react withother inflammatory molecules, such as lipopeptides, LTAs or LAMs(lipoarabinomannans), which are all TLR2 agonists. Thus, this resultsuggests that this sample which is uncontaminated in terms of absence ofLPS and of PGN contains other pro-inflammatory molecules which are TLR2agonists.

With the exception of the I-10.01 and I-10.03 samples, all the samplesgive a positive response with the Raw-Blue cells (FIG. 18).

The level of LPS present in the I-10.02 sample is close to the detectionthreshold of the LAL test, which indicates that the response observed isdue to the presence of PGN. This result confirms that, contrary to theTHP-1 cells which do not respond to this sample, the Raw-Blue cells areeffective for detecting small contaminations with PGN. The strongresponse of the I-11.12, MM-10.05 and MP-10.07 batches therefore appearsto be due to the presence of the two contaminants (PGN and LPS).

Like the HEK-TLR2 cells, the Raw-Blue cells respond positively toMP-10.06, which confirms the presence of a contaminant other than LPSand PGNs in this sample.

Finally, the HEK-NOD2 cells react strongly in the presence of MP-10.07,and give a weak but significant response with the I-10.03, MM-10.04 andMP-10.06 samples, which indicates that these samples were contaminatedwith PGNs during a step of their production, and that the latter werepartially degraded during the course of production of the product (FIG.19).

The HEK-TLR2 and Raw-Blue cells are effective for detecting traces ofinflammatory contaminants in products of I-10.01 and I-10.03 type.

They even have characteristics that are complementary to the sensitizedTHP-1 cells. Indeed, the tests using the three of them make it possibleto detect the majority of inflammatory contaminants that may be presentin glucose polymer samples.

-   -   THP-1: any inflammatory contaminant with a high reactivity for        LPS.    -   Raw-Blue: any inflammatory contaminant with a high reactivity        for PGNs.    -   HEK-TLR2: specific for TLR2 agonists with a high reactivity for        PGNs.    -   HEK-NOD2: specific for MDP and consequently for PGN degradation        products. As for the THP-1 cells, an absence of proportionality        between the levels of PGN and/or of LPS and the amplitudes of        the cell responses is also noted.

This problem is doubtless linked to the size of these macromoleculesand/or to their presence in the form of aggregates, which influencestheir reactivity with respect to the cells. Thus, it was observed thatpassing the standard PGN through a 0.22 μm filter reduces byapproximately 50% the reactivity thereof for the HEK-TLR2 cells.Consequently, in all the tests, the glucose polymer solutions areprepared under aseptic conditions but without a step of filtration ofthe standard molecules.

EXAMPLE 4 Characterization of the Contaminants by Using the SensitizedTHP-1, the HEK-Blue™ (hTLR2, hNOD2) and the Raw-Blue™ Cell Lines

Examples 2 and 3 show that the sensitized THP-1, the HEK-TLR2, theHEK-NOD2 and the Raw-Blue lines are effective for detecting traces ofinflammatory contaminants in the glucose polymer samples. In addition toLPS and MDP, the presence of which is detected via the TLR4 and NOD2receptors, the other contaminants that may be present in the samples arepredominantly TLR2 ligands (PGN, LTA and lipopeptides). Consequently,the lines do not make it possible to establish the contribution of thePGNs in the TLR2-specific response. However, PGNs are macromolecules ofwhich the weight ranges from ˜100 kDa to several million Da. Conversely,LTAs and lipopeptides have low weights, less than 15 kDa. Thus, theintroduction of an ultrafiltration step (30 kDa) should make it possibleto retain the PGNs and to measure only the response to TLR2 ligands ofsmall sizes.

Experimental Procedures

For the experiments relating to this example, the five cell linespresented in examples 2 and 3 are used:

-   -   THP-1 monocyte line: response to any inflammatory contaminant        with a high reactivity for LPS,    -   Raw-Blue™ line: response to any inflammatory contaminant with a        high reactivity for PGNs,    -   HEK-Blue™ hTLR2 line: specific for TLR2 agonists with a high        reactivity for PGNs,    -   HEK-Blue™ hNOD2 line: specific for PGN total depolymerization        products (MDP),    -   HEK-Blue™ Null line: negative response control.

The glucose polymer samples are presented in example 2 (Table 1). Thesesamples are prepared in solution at the concentrations described inexamples 2 and 3. The cell responses (production of RANTES for the THP-1cells and secretion of SEAP for the Blue™ cells) are analyzed eitherwith the nonfiltered samples: Total response, or with the filtratesobtained by ultrafiltration on a microconcentrator with a cut-offthreshold at 30 kDa (Sartorius): Filtrate response.

Before use, the microconcentrators were treated with a saline solution(150 mM NaCl) prepared with non-pyrogenic water. The retentates andfiltrates were tested with the cell lines, and only the filters giving anegative response in each test were retained for the analyses with theglucose polymer samples.

Results

The results presented in FIG. 20 show the responses of the HEK-TLR2 andRaw-Blue cells obtained in the presence of the various samples beforeand after ultrafiltration.

The Total responses are similar to those observed in example 3 (FIGS. 17and 18).

The Filtrate responses are greatly reduced for the I-10.02 and I-11.12samples in the two cell types, with values close or equal to thedetection thresholds. These data confirm that these two samples arecontaminated with PGN, which was retained by the filter.

The filtrate response of MM-10.05 is reduced in the HEK-TLR2 cells, butnot in the Raw-Blue cells, indicating that this sample is contaminatedwith a combination of several molecules, with a considerable partcontributed by PGN.

The MM-10.04, MP-10.06 and MP-10.07 samples are not significantlycontaminated with PGN, since the Total and Filtrate responses areidentical in the HEK-TLR2 cells. On the other hand, a 50% decrease inthe Filtrate response can be noted for MP-10.07 in the Raw-Blue cells.The LAL test showed that this sample is loaded with LPS. Although theweight of endotoxins is less than 30 kDa, these molecules are capable offorming aggregates, which may account for the loss of response afterfiltration.

The Total and Filtrate responses were analyzed in the THP-1, Raw-Blue,HEK-TLR2 and HEK-NOD2 cell types. The results are given in Table 4.

For the HEK-NOD2 cells, the Total and Filtrate responses are identical,which was expected since MDP and the related molecules have a weightmuch less than 30 kDa (MW^(˜)500 Da). Only the Total responses arereproduced in Table 4.

TABLE 4 Characterization of the contaminants by analysis of the cellresponses. I- I- I- I- MM- MM- MP- MP- Response 10.01 10.02 10.03 11.1210.04 10.05 10.06 10.07 THP-1 − − ± + + ± ± + <30 kDa − − ± ± ± ± ± ±Raw-Blue − + ± + ± + ± + <30 kDa − − − − ± ± ± + HEK-TLR2 − ++ ± +++ ±++ ± ± <30 kDa − − ± − ± ± ± ± HEK-NOD2 − − ± − + − + ++ Major effectnegative PGN residues PGN residues PGN and residues LPS and includingresidues including residues MDP MDP The contamination levels areexpressed as a function of the threshold limits of detection (LOD) andof the EC50s defined in examples 2 and 3 for each cell type (Tables 2and 3), with the dose-response curves with respect to LPS for thesensitized THP-1 cells, with respect to PGN for the Raw-Blue andHEK-TLR2 lines, and with respect to MDP for the HEK-NOD2 line: (−):level < LOD; (±): LOD ≦ level < 3 × LOD; (+): 3 × LOD ≦ level < 0.3 ×EC50; (++): 0.3 × EC50 ≦ level < 3 × EC50; (+++): level ≧ 3 × EC50

The data make it possible to characterize the types of contaminantspresent in each glucose polymer solution and to establish theircontribution in the inflammatory response:

I-10.01: sample not contaminated.

I-10.02: sample strongly contaminated with PGN. The absence of responseof the THP-1 and HEK-NOD2 cells and of the Filtrates indicates that thecontribution of the other contaminants is negligible.

I-10.03: sample weakly contaminated with residues probably originatingfrom degradation products of small size. Indeed, the Total and Filtrateresponses are at the limit of the background noise in all the tests.

I-11.12: sample strongly contaminated with PGN. The weak response of theTHP-1 cells also points to traces of LPS.

MM-10.04: sample weakly contaminated with LPS and TLR2-activatingmolecules of small size (LTA, lipopeptides). The presence of MDP alsopoints to PGN degradation products.

MM-10.05: sample contaminated with PGN and other molecules of smallsizes. The weak responses of the other tests suggest the presence oftraces of LPS and of other TLR2 ligands.

MP-10.06: sample contaminated with numerous small molecules. On theother hand, the weak THP-1 and HEK-TLR2 responses indicate the absenceof PGN and of LPS.

MP-10.07: sample contaminated with numerous small molecules, with a highproportion of LPS and of MDP.

It may be noted that the results match the Wako SLP-HS assays for theI-10.01, I-10.02, I-10.03 and I-11.12 samples, which are final products,and the MM-10.04 and MP-10.06 samples, which were identified as beingdevoid of PGN.

On the other hand, the two MM-10.05 and MP-10.07 samples give PGNresponses that are weaker than those expected with the data of the SLPtests. However, it is possible that these samples gave false positiveswith the SLP tests, via crossreaction with β-glucans, for example.Another possibility is that these samples contain very large PGNs, thelow solubility of which prevents the triggering of a response in thecell tests.

EXAMPLE 5 Peptidoglycan Assay Method

The assay is based on the specific recognition of PGNs by a lineexpressing the TLR2 receptor and on the production of an enzymaticactivity that is measurable via the activation of the signaling pathwayassociated with TLR2.

Experimental Procedures

For the experiments relating to this assay, two lines are used:

-   -   HEK-Blue™ hTLR2 line;    -   HEK-Blue™ Null2 line.

The two lines are presented in example 3.

Establishment of the Dose-Response Curve

The dose-response curve was produced with standard S. aureus PGN (FIG.21).

The HEK-Blue™ cells are incubated with increasing concentrations ofstandard, and the cell response is measured by quantifying the enzymaticactivity produced.

The result is a conventional sigmoid cell response curve:

-   -   part (A) corresponds to the responses obtained with low        concentrations of PGN, below those which give effective        activation of TLR2. This nonlinear zone therefore corresponds to        the threshold limit of detection of the method. In such a way as        to include the variability of the method, this detection        threshold is estimated at three times the value of the        background noise (response obtained in the absence of stimulus).    -   part (B) is the most interesting since a linear response is        observed. This effective-response zone makes it possible to        determine a direct relationship between the cell response and        the level of PGN. It is therefore the assaying zone;    -   part (C) corresponds to a saturation of the cell response in the        presence of PGN concentrations which are too high. There is in        fact a saturation of the TLR2 receptors.

The standard curve for response of the HEK-TLR2 cells to PGN exhibits alinearity zone for concentrations between 0.07 and 10 ng/ml (i.e.between 2 and 267 ng/g).

In the case of samples that may be highly contaminated with PGN, it willbe necessary to perform several serial dilutions so as always to be inthe linearity zone. Conversely, low PGN concentrations require a step ofconcentrating the sample if it is desired to increase the sensitivity ofthe assay.

Sample Preparation

The PGN assays are carried out on glucose polymer solutions. The samplerequiring the PGN quantification is incubated with HEK-Blue™ hTLR2cells, and the cell response is measured by quantifying the enzymaticactivity produced. The amount of PGN contained in the sample can bedetermined by referring to the dose-response curves.

The first tests were carried out with contaminated samples originatingfrom manufactured glucose polymer batches (example 3, FIG. 15).

The HEK-TLR2 cells make it possible to detect the presence of PGN in themajority of the samples. On the other hand, it was observed that thereis no correlation between the PGN levels measured by the SLP-Wako methodand the amplitudes of the cell responses to PGN. Indeed, the sampleswith the highest PGN load are not those which induce the strongestproduction of SEAP.

By way of illustration, the MP-10.07 sample, which is the one mosthighly loaded with PGN (645 ng/mg), does not give a marked cell responsewith the HEK-TLR2 cells. Conversely, the I-10.02 and I-11.12 samples areless contaminated (253 and 393 ng/g, respectively), but are the mostreactive in terms of cell response.

PGNs have very heterogeneous sizes. The heaviest forms (>10⁶ Da) havelow solubility and are therefore not very reactive in the cell tests. Onthe other hand, they are assayed by the SLP-Wako test. The PGNs ofintermediate size (˜100 kDa) are very soluble and are powerful inducersof TLR2. Despite low levels, they are capable of triggering a stronginflammatory response. This size dispersion and therefore activitydispersion is a major drawback for relating the contamination level tothe risk of developing an inflammatory response when conventionalquantitative assays are used (LAL and SLP-Wako).

The PGNs present in the I-10.02 and I-11.12 samples are soluble andtherefore very reactive. Conversely, the MP-10.07 sample probablycontains PGNs of large size, which will be removed in the course of theproduction of the final product.

On the basis of these first results, the PGN assay method based on theuse of the HEK-TLR2 cells would therefore make it possible to quantifythe biologically active PGNs capable of causing inflammatory reactionsin vivo.

A particularly advantageous procedure for assaying the PGNs capable oftriggering an inflammatory response is to reduce their size, andtherefore increase their solubility for the in vitro cell response test.

Mutanolysin is an enzyme which, through its muramidase activity, iscapable of depolymerizing PGNs. In order to test its activity, solutionsof standard (S. aureus) PGN were prepared by diluting the molecule inculture medium in the absence or in the presence of the I-10.01 polymer(noncontaminated polymer) at the concentrations of 7.5% and 37.5%(weight/volume).

The samples were treated in the presence of 2500 U/ml of mutanolysin for16 h at 37° C., and then added to the HEK-TLR2 cells. The cell responsewas measured by following the activity of the SEAP produced, accordingto the conditions described in example 3.

In the absence of glucose polymer, the treatment with mutanolysin for 16h reduces the response of the HEK-TLR2 cells by more than 50%,indicating that the depolymerization was too strong and reduced thereactivity of the PGN with respect to the cells. Conversely, thepresence of the glucose polymer reduces the activity of the enzyme,since the response of the cells is even improved in the presence of 7.5%of polymer, whereas it is unchanged in the presence of 37.5% of polymer.

Mutanolysin alone does not induce any cell response, indicating that itis not contaminated and that it has no activating effect on the cells.

In order to verify the effect of this treatment, the I-10.01, I-10.02,I-10.03, I-11.12, MM-10.05 and MP-10.07 polymers were diluted to theconcentration of 7.5% and then treated for 16 h at 37° C. in the absenceor in the presence of 2500 U/ml of mutanolysin.

The cell response was induced by adding 40 μl to 160 μl of cellsuspension (final polymer concentration: 15 mg/ml).

Results

The responses of the HEK-TLR2 cells in the presence of the untreatedpolymers are weak, which was expected given the lower polymerconcentration compared with example 3.

After mutanolysin treatment, the responses to the glucose polymersolutions are clearly increased (FIG. 22). In addition, it may be notedthat the I-10.03 polymer gives a response equivalent to the I-10.02 andMM-10.05 polymers, even though it was not reactive in the previoustests.

These results indicate that the mutanolysin partially depolymerized andtherefore solubilized PGNs which were totally or partially insolubleowing to their excessively large size.

The absorbance values were reported on the calibration curvesestablished under the same conditions with the standard PGN (FIG. 23),so as to determine the PGN concentrations present in the glucosepolymers.

The results expressed as ng of PGN/g of glucose polymer are reported intable 5. After mutanolysin treatment, the values are lower than thoseobtained with the SLP-Wako tests, but they reflect the load of theglucose polymers in terms of PGN with pro-inflammatory activity (Table1).

The I-10.03 polymer gives a high value, close to I-10.02, aftermutanolysin treatment. This piece of data is interesting since the twopolymers have been the subject of complaint owing to episodes of asepticperitonitis. The mutanolysin treatment of I-10.03 therefore made itpossible to reveal the active PGN load, probably by enabling thecontaminant to be solubilized.

The values of the MM-10.05 and MP-10.07 samples remain lower than thoseobtained with the SLP tests. However, these samples are contaminatedwith other inflammatory molecules other than PGNs. These molecules, andin particular the β-glucans, probably interfered in the SLP assays,increasing the response of the SLP tests.

TABLE 5 Assaying of PGNs present in the glucose polymers before andafter mutanolysin treatment. The values are expressed in ng S. aureusPGN equivalent/g of polymer. I- I- I- I- MM- MP- 10.01 10.02 10.03 11.1210.05 10.07 without <2 13.5 <2 17.5 11.5 3.5 treatment with <2 33.5 36.8113.5 36 13.5 treatment

1-30. (canceled)
 31. A method for detecting pro-inflammatorycontaminants of glucose polymers comprising contacting a cell line witha composition comprising glucose polymers, the cell line being either amacrophage cell line, a macrophage-differentiated cell line or a cellline expressing one or more Toll-Like Receptors (TLRs) or NOD-likereceptors and performing an inflammatory response test to detect aninflammatory response produced by said cell line.
 32. The method asclaimed in claim 31, wherein the glucose polymers are glucose polymersfor peritoneal dialysis, for enteral feeding, for parenteral feed or thefeeding of newborn babies.
 33. The method as claimed in claim 31,wherein the cell line is a macrophage cell line or amacrophage-differentiated cell line.
 34. The method as claimed in claim33, characterized in that the inflammatory response test comprisescontacting the cells of the cell line with a preparation of glucosepolymers that may contain pro-inflammatory contaminants and in measuringproduction of cytokines of the acute phase of inflammation, theproduction of said cytokines indicating that the preparation containscontaminants capable of triggering an inflammatory reaction.
 35. Themethod as claimed in claim 34, wherein the cytokines of the acute phaseof inflammation are selected from the group consisting of TNF-α, IL-1βand chemokines.
 36. The method as claimed in claim 35, wherein thechemokine is RANTES.
 37. The method as claimed in claim 34, wherein amolecule chosen from muramyl dipeptide (MDP), L18-MDP, glycolyl-MDP,formyl-Met-Leu-Phe or lipopolysaccharide is added to the glucose polymerpreparation.
 38. The method as claimed in claim 37, wherein MDP or LPSis added to the glucose polymer preparation.
 39. The method as claimedin claim 34, wherein said inflammatory response test is performed underone or more of the following conditions: the cell line is used at adensity of between 0.5 and 1×10⁶ cells/ml, preferably between 0.7 and0.8×10⁶ cells/ml, and even more preferably approximately 0.75×10⁶cells/ml; and/or the glucose polymer concentration is less than 50mg/ml, preferably approximately 25 mg/ml; and/or the cytokine productionis measured after 20 h of stimulation for RANTES and/or 8 h ofstimulation for TNF-α; and/or MDP is added, to the glucose polymerpreparation, at a concentration of between 1 and 100 μg/ml.
 40. Themethod as claimed in claim 33, wherein detection of glucose polymercontamination with peptidoglycans (PGNs) and/or LPS is detected.
 41. Themethod as claimed in claim 31, wherein the cell line contains a reportergene under the direct control of the signaling pathway associated withthe TLR(s) or NOD-like receptor(s) that makes it possible to detect theactivity of one or more Toll-Like Receptors (TLRs) or NOD-like receptorsin said cell line.
 42. The method as claimed in claim 41, wherein saidcell line contains a reporter gene under the direct control of thesignaling pathway associated with a TLR2 receptor.
 43. The method asclaimed in claim 41, wherein said cell line contains a reporter geneunder the direct control of the signaling pathway associated with a NOD2receptor.
 44. The method as claimed in claim 41, wherein said cell linecontains a reporter gene under the direct control of the signalingpathway associated with a TLR4 receptor.
 45. The method as claimed inclaim 41, wherein said cell line contains a reporter gene under thedirect control of the signaling pathway associated with TLR2, TLR4 andNOD2 receptors.
 46. The method as claimed in claim 41, wherein saidinflammatory response test comprises contacting cells of the cell linewith a composition comprising glucose polymers that may containpro-inflammatory contaminants and in measuring the activity of thereceptor or the signal of the reporter gene, the detection of thisactivity or of this signal indicating that the preparation containscontaminants capable of activating one or more innate immunity receptorsand of triggering an inflammatory reaction.
 47. The method as claimed inclaim 43, wherein said method detects the contamination of the glucosepolymer composition with MDPs.
 48. The method as claimed in claim 42,wherein said method detects the contamination of the glucose polymercomposition with PGNs.
 49. The method as claimed in claim 31, whereinthe glucose polymer preparation tested has a polymer concentration offrom 5 to 50 mg/ml.
 50. The method as claimed in claim 31, wherein saidmethod comprises a step of treating the glucose polymer preparation witha mutanolysin prior to the incubation of said preparation with thecells; or a step of filtration of the glucose polymer preparation with acut-off threshold of between 30 kD and 150 kD and the filtrate isincubated with the cells, and optionally in that the results on thefiltrate are compared with the results on the glucose polymerpreparation.
 51. The method as claimed in claim 31, wherein said methodcomprises: (a) carrying out at least one in vitro inflammatory responsetest comprising contacting macrophages with a composition comprisingglucose polymers that may contain pro-inflammatory contaminants and inmeasuring the production of cytokines of the acute phase ofinflammation, the production of said cytokines indicating that thepreparation contains contaminants capable of triggering an inflammatoryreaction, and (b) placing a cell line which makes it possible to detectthe activity of an innate immunity receptor or several innate immunityreceptors in the presence of the composition and detecting the activityof the receptor or the signal of the reporter gene associated with thisreceptor, the detection of this activity or of this signal indicatingthe presence, in the preparation, of a contaminant which is an agonistof the receptor.
 52. The method as claimed in claim 51, wherein saidmethod comprises performing a test (a) with macrophages and a test (b)with cells which makes it possible to detect the activity of the TLR2receptor, and optionally a test (b) with cells which make it possible todetect the activity of the NOD2 receptor and/or a test (b) with cellswhich make it possible to detect the activity of the TLR2, TLR4 and NOD2receptors.
 53. The method as claimed in claim 31, wherein said methodalso comprises a step of identifying or quantifying the contaminant(s)capable of triggering an inflammatory reaction.
 54. The method asclaimed in claim 53, wherein the contaminant(s) capable of triggering aninflammatory reaction is (are) identified or quantified by placing theglucose polymer preparation in the presence of the cells of a cell lineas defined in claim 41 and by measuring the activity of the receptor orthe signal of the reporter gene, the detection of this activity or ofthis signal indicating the presence, in the preparation, of acontaminant which is an agonist of the receptor.
 55. The method asclaimed in claim 54, wherein the quantification of peptidoglycans (PGNs)is performed with a cell line that contains a reporter gene under thedirect control of the signaling pathway associated with the TLR2receptor that provides for the detection of the activity of said TLR2receptor.
 56. The method as claimed in claim 55, wherein saidcomposition comprising glucose polymers is treated with a mutanolysin,incubation of treated and untreated glucose polymer compositions withsaid cell line and quantification of the PGNs.